Heart attack victims should opt for Mediterranean diet - but go easy on the fish

Heart attack survivors should eat a Mediterranean-style diet and exercise every day to avoid the risk of dying prematurely, says new guidance.

It says 1.5 million people who have had a heart attack should consume more bread, fruit, vegetables and fish, and less cheese and meat, with plant oils replacing butter.

But, for the first time, people are being advised against eating oily fish, or taking omega-3 supplements or food fortified with omega-3, specifically to prevent a further attack.

Heart attack survivors had been advised to eat two to three portions of oily fish - such as herring or mackerel - a week.

Heart attack survivors should eat fish as part of a Mediterranean-style diet, according to new health guidelines

The draft guidance from the National Institute for Heath and Care Excellence (Nice) says new treatments have made this approach redundant.

It says ‘New evidence shows that the risk of cardiovascular events such as heart attacks or strokes, is very different today because of new treatments that are now available.

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‘This means that any impact an oily fish diet may have on preventing further heart attacks or strokes could be minimal.’ Fish should be eaten as part of a Mediterranean-style diet by heart attack survivors, it says.

This diet should also include more bread, fruit and vegetables, cutting back on meat, butter and cheese, and consuming more products based on plant oils.

Heart-healthy: Vegetables and vegetable oils should be used in place of butter in order to prevent another attack

Cheese and meat consumption should be reduced in favour of fruit, bread and vegetables

Survivors are recommended, along with all Britons, to eat fish at least twice a week, including one portion of oily fish.

Almost 80,000 hospital admissions were caused by heart attacks in England and Wales in 2011.Twice as many men had heart attacks as women.

Currently one million men and nearly 500,000 women in the UK have had a heart attack and rates of survival have improved since the late 1990s.

This is due to clotbusting drugs given immediately following a heart attack and therapies such as blood pressure lowering agents to prevent subsequent attacks.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said ‘Despite the improvements in the number of people surviving a heart attack, heart disease remains the UK’s biggest killer, causing more than 80,000 deaths each year.

‘It also causes ongoing health problems for many thousands of others. People who have had a heart attack have a greatly increased risk of another.

‘Healthcare professionals should ensure that a programme of education and activity to help people recover from a heart attack and lead their lives as normally as possible, is designed to motivate people to attend and complete it.

‘People who have had a heart attack should also be encouraged to eat a healthier, Mediterranean-style diet, and exercise daily in order to reduce their risk of a further heart attack’ he added.

The guideline includes advice on the use of stents to widen arteries after a heart attack, new antithrombotic drugs to prevent blood clots and the use of drugs to cut blood pressure and control heart rhythm.

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, said: 'It’s one thing to save a life, it’s another thing giving patients a life worth saving. Only 44 per cent of eligible patients currently receive cardiac rehabilitation, despite the evidence demonstrating it can reduce premature death.

‘Interestingly, oily fish is no longer on the menu for those who have had a heart attack, but the benefits of a Mediterranean diet are helpfully emphasised in the guidance.

‘It remains to be seen how quickly the NHS can implement any new guidelines.’